Mental Health Issues in Military Personnel and Veterans: An Overview
Traumas are events in which a person has the feeling that he or she may die or be seriously injured or harmed, or events in which he or she witnesses such things happening to others. Trauma is of course common among active military persons and veterans, and in addition to the immediate consequences of intense fear, helplessness, or horror, there are sometimes longer-lasting stress reactions that can be surprising, distressing, and difficult to understand. This fact sheet is intended to help military personnel, veterans, and their family members understand the nature of trauma and its consequences.
In reviewing the list of effects of trauma below, keep in mind that:
- It is very common to have problems following exposure to war or other trauma. But traumatic stress reactions often become less frequent or distressing as time passes, even without treatment.
- People with traumatic stress often worry that they are going crazy. This is not true. Rather, what is happening is that they are experiencing a set of common symptoms and problems that are connected with trauma.
- Problems that result from trauma are not signs of personal weakness. Many mentally and physically healthy people experience stress reactions that are distressing and interfere with their daily lives following exposure to traumatic experiences. But if traumatic stress reactions continue to cause problems for more than a few weeks or months, treatment can help reduce them.
Here are some common (often temporary) consequences of trauma:
Unwanted remembering or re-experiencing
Almost all veterans experience difficulty controlling distressing memories of military experience, particularly when there has been combat experience. Although these memories are upsetting, on the positive side, the memories provide an opportunity for the person to make sense of what happened and gain mastery over the event. The experience of these memories can include:
- Unwanted distressing memories as images or other thoughts
- Reexperiencing of the original traumatic situation, or the feeling like it is happening again (flashbacks)
- Dreams and nightmares
- Distress and physical reactions (e.g., heart pounding, shaking) when reminded of the trauma
Physical activation or arousal
The body's fight-or-flight reaction to a life-threatening situation helps prepare persons in a dangerous situation for quick response. Unfortunately sometimes this pattern of activation or arousal continues long after the event is over. Signs of continuing physical activation, some of which are somewhat common following military experience, can include:
- Difficulty falling or staying asleep
- Irritability, anger, and rage
- Difficulty concentrating
- Being constantly on the lookout for danger (hyper-vigilance)
- Being startled easily for example, when hearing a loud noise (exaggerated startle response)
- Anxiety and panic
Shutting down: Emotional numbing
Another survival response involves the shutting down and numbing of emotional response in times of trauma. As a result, some military personnel and veterans may have difficulty experiencing loving feelings or feeling some emotions, especially when upset by traumatic memories.
Active avoidance of trauma-related thoughts and feelings
Painful memories and physical sensations of fear can be frightening, so it is only natural to try to find ways to prevent them from happening. One way that many trauma survivors including veterans might do this is by avoiding anything people, places, conversations, thoughts, emotions and feelings, physical sensations that might act as a reminder of the trauma. This process can be helpful if it is selective and specific (for example, in avoiding upsetting news or television programs). But when avoidance is used too much, it can have two big negative effects. First, it can reduce the ability to live life fully and with enjoyment as people become isolated and limited in where they go and what they do. Second, avoiding thoughts and emotions connected with the trauma may reduce the ability to recover from the trauma. It is through thinking and talking about the traumatic experience with trusted others, a process that some term “working through the trauma,” that survivors may come to manage and integrate the traumatic experience. By constantly avoiding thoughts, feelings, and discussions about the trauma, this potentially helpful process can be short-circuited.
Depression
Most persons who have been traumatized experience short-term depression. But when this experience lasts too long it becomes an area of concern, and may involve:
- Feelings of helplessness and hopelessness
- Loss of pleasure in usual activities
- Lower energy
- Pervasive and extreme sadness (“I don’t know why, but I’m just crying all the time,” some people with depression say)
- Changes in appetite and sleeping patterns
Depression is a serious and life-threatening struggle. It is important to let others know about feelings of depression and, of course, about any suicidal thoughts and feelings, which are sometimes a part of feeling depressed.
Self-blame, guilt, and shame
In trying to make sense of their traumatic war experiences, many military personnel and veterans blame themselves or feel guilty in some way. They may feel
bad about some thing(s) they did or didn't do in the war zone. Feelings of guilt or self-blame cause much distress and can prevent a person from reaching out for help. Therefore, even though it is hard, it is very important to talk about guilt feelings with a mental health professional.
Interpersonal problems
Not surprisingly, the many changes noted above can affect relationships with partners, family, friends, or co-workers. Particularly in close relationships, the emotional numbing and feeling of disconnection that are common after traumatic events may create distress and drive a wedge between the survivor and his or her family or close friends. The survivor's avoidance of different kinds of social activities may frustrate family members and contribute to isolation. And other people who don’t understand trauma may respond in ways that worsen the problem rather than help recovery. They may become angry with the active duty person or veteran, communicate poorly, and fail to provide support. Just as the military person needs to learn about trauma and its effects, people who are important to him or her also need to become educated so as to be empathic and kind.
Physical symptoms and health problems
Because many traumas result in physical injury, pain is often part of the experience of veterans. This physical pain often causes emotional distress, because in addition to causing pain and discomfort, the injury also reminds them of their trauma. Because traumas stress the body, they can sometimes affect physical health, and survivors may experience stress-related physical symptoms, such as headaches, nausea or other stomach problems, and skin problems.
Some of the information in this fact sheet is based on information found here.
Web Links
Veterans Heart Georgia: This grass roots organization utilizes innovative approaches to helping veterans of all wars with the entire spectrum of the effects of war and military service. The organization is made up of veterans, mental health professionals and citizens.
CareForTheTroops Inc. is a 501c3 Non-Profit formed to develop a network of civilian faith communities, civic organizations, and networks of therapists all trained and able to work with the military members, veterans, and their families as they adjust to the changes experienced during and after returning from deployments and combat.
Iraq and Afghanistan Veterans of America Our Mission: IAVA’s mission is to improve the lives of Iraq and Afghanistan veterans and their families.
This is the information forGeorgia’s largest provider of VA services and the web site address.
Atlanta VA Medical Center 1670 Clairmont Road Decatur, GA 30033
Phone: (404) 321-6111 hrs. 8:00a.m-4:30p.m.
Website www1.va.gov/Atlanta
24-hour VA suicide hot line : 1-800-273-TALK
America's Heroes at Work: Welcome to America's Heroes at Work - a U.S. Department of Labor (DOL) project that addresses the employment challenges of returning service members living with Traumatic Brain Injury (TBI) and/or Post-Traumatic Stress Disorder (PTSD).
U.S. Vets Over 200,000 veterans will sleep on the streets of our nation tonight. Our VISION is that one day there will no longer be homeless veterans in America...U.S. VETS provides housing, counseling, job assistance, and HOPE to thousands of homeless veterans each year. Our programs foster the skills necessary for every veteran to return to the community and remain self-sufficient.
This is a link provided by the US army for soldiers that help with some information on stress, suicide facts, and some veteran benefits that are available.
Welcome Back Veterans is resource to help welcome back veteran returning from deployment.